Diabetes Drugs that Lower Heart Risks

Of all the complications of diabetes, including blindness, neuropathy (i.e., nerve pain), amputations, and kidney failure, the most dangerous—heart disease—is often paid the least attention. Yet people with diabetes are more than twice as likely to develop heart problems than those without diabetes, and the majority of people with type 2 diabetes will eventually die from cardiovascular ills such as heart attacks.

Medicine has long sought to develop medications that can improve both glucose control and heart health, even dubbing this target the holy grail of diabetes research. Now the goal appears to be in sight.

In a multi-site study presented at the American Diabetes Association’s annual meeting last June, a medication called liraglutide, one in a class of drugs known as GLP-1 agonists, lowered the risk of first-time heart attack, stroke, or cardiovascular death in patients with diabetes by 13 percent. Use of the drug also resulted in a 22 percent reduction in death from heart-related causes and a 15 percent reduction in all-cause mortality.

GLP-1 agonists work in the pancreas to curb the production of an anti-insulin hormone called glucagon. Primarily they boost insulin production and help control blood sugar. But they also help to lower appetite and increase feelings of satiety, spurring weight loss, which may help to explain the drugs’ heart benefits. One called semaglutide, which is currently under investigation, reduced the risk of heart attack, stroke and cardiovascular death by 26 percent among adults with type 2 diabetes at high risk for heart disease.

Other diabetes medications have shown similarly encouraging results. Researchers recently showed that one called empagliflozin slashed cardiovascular deaths by 38 percent and hospitalizations due to heart failure by 35 percent.

Of course, people with diabetes should also strive to control their blood sugar levels through lifestyle measures like a balanced diet, regular exercise and weight loss if needed, which have proved to be remarkably effective. Carefully monitoring A1C levels, a measure of glucose control over time, is important. In addition patients with diabetes may benefit from GlycoMark®testing, which shows how often high glucose levels spike over 180 mg/dL in a two-week period, catching high blood sugar levels that damage blood vessels before they would become apparent on an A1C test.

People at risk for diabetes should talk to their practitioners about options for preventing the disease and ask about tests that can help to predict their future risk of diabetes. These include oxidized LDL testing and adiponectin testing. People with low levels of adiponectin, a hormone released by fat cells that helps control how the body uses sugars and fats from foods, are at greater risk for metabolic syndrome, often a precursor to diabetes. High levels of LDL cholesterol are linked to a higher risk for metabolic syndrome.

More research is needed to confirm study results of the new heart-friendly diabetes drugs, but investigators and practitioners are enthusiastic about these new tools. As one in three Americans is expected to have diabetes by 2050, many with deadly complications, the news—and new tactics for countering the epidemic—can’t come soon enough.